Implementation of a Treatment Program for Individuals Imprisoned for Sex Offenses in Uruguay: Achievements, Problems and Challenges.

Treatment for individuals convicted of sex offenses has substantially improved in developed countries in recent decades, providing practitioners with an extensive literature to guide the implementation of effective programs to reduce sexual reoffending. Nevertheless, sexual offending rehabilitation is still in its infancy in Latin American countries such as Uruguay, so little is known about the transference and implementation of evidence-based programs. The current study examines the strengths, barriers, and challenges of implementing a sex offenses treatment program in Uruguay. The findings suggest some achievements of the program, but also several problems with implementation. Some problems are universal among different countries (e.g., scarce resources and facilities, insufficiently trained staff, and unexpected changes in the organization), but others were particularly relevant in the Uruguayan context (e.g., government policy alien to a rehabilitation approach, lack of appropriate prison facilities, lack of training for therapists from a cognitive-behavioral perspective). All these difficulties must be anticipated and solved for successful generalizability of rehabilitation programs to different correctional systems.

Treatment and Therapeutic Change of Individuals Imprisoned for Child Abuse in the Barcelona Study on Sex Offenders.

The sexual abuse of children is a serious social problem that must be prevented through distinct measures. Among them is the application of treatments to those who have already committed sex crimes in order to prevent them from committing a new one. To assess the efficacy of sexual offense treatment, the most common method has been to compare the recidivism rates of treated and untreated groups. Several meta-analyses in this regard-as well as some specific studies in Spain-have shown that the application of treatment is associated with lower recidivism rates. However, the analysis of the subjects' recidivism alone does not reveal the therapeutic changes that the treatment may elicit in them. Some international studies have evaluated the therapeutic improvements resulting from the application of treatments to men who had sexually abused children. In this context, this study explores the therapeutic changes experienced by a sample of subjects imprisoned for child abuse (N = 145), after participating in the treatment program applied in the Spanish prison system. Nine therapeutic variables were assessed (such as anxiety, cognitive distortions, impulsivity, and social self-esteem), before and after treatment, using an instrument named the Psychological Assessment Scale for Sex Offenders (PASSO). The obtained results show that most of the assessed therapeutic variables improved after treatment, with strong correlations between them. The implications of the results for treatment practice are discussed, as well as the main methodological limitations of this research.

A Dynamic Risk Factors-Based Typology of Sexual Offenders.

The purpose of this article was to develop an Spanish psychometric typology of sexual offenders taking into account dynamic risk factors. The sample comprised 94 sex offenders imprisoned in Spain (52 rapists and 42 child molesters). The analysis yielded two different offender categories based on the subjects' criminogenic needs level (high and low). The results also showed that social desirability has a strong influence on the developed typologies, whereas the offence type, sociodemographic characteristics, and criminal history do not. A dynamic risk factors typology, such as the one proposed here, could help criminal and correctional facilities to fulfill their remit. It could also be useful for linking treatment intensity to offenders' criminogenic needs, as well as providing a platform for recidivism risk assessments.

Psychological treatment and therapeutic change in incarcerated rapists / Tratamiento psicológico y cambio terapéutico en agresores sexuales encarcelados

Most Spanish prisons provide specialised treatment for incarcerated sex offenders, both rapists and child molesters. This treatment is a cognitive-behavioural intervention that has shown relative effectiveness in previous research. With regard to offenders’ rehabilitation, recidivism assessments are necessary as a final measure of treatment effectiveness. However, the evaluation of recidivism by itself does not provide sufficient information on the treatment process and the specific effects that treated subjects could undergo. This paper aims to analyse the therapeutic effectiveness of psychological treatment provided to rapists (in general, males sentenced for committing a sexual offence against women). To this aim, a group of treated rapists (N=153) serving a sentence in prison was analysed. Using a specially designed scale (PASSO), the global therapeutic change and ten specific variables (including assertiveness, readiness to change, cognitive distortions, impulsivity, etc.) were assessed. The within-subjects comparison showed that treated sex offenders improved, in therapeutic terms, globally as well as in most of the specific variables assessed (improvements not experimented by the control group). Also, different therapeutic subscales showed relevant associations between them. The findings regarding treatment effectiveness are discussed (AU)

La mayoría de los centros penitenciarios españoles ofrecen un programa de tratamiento psicológico especializado para agresores sexuales, tanto para violadores como para abusadores de menores. Se trata de un programa de orientación cognitivo-conductual, que en algunas evaluaciones ya realizadas ha evidenciado una eficacia terapéutica relativa en términos de reducción de las tasas de reincidencia. Aunque la evaluación de la reincidencia delictiva sea una medida necesaria para ponderar la eficacia final del tratamiento de los agresores sexuales, dicha medida no permite conocer con precisión las mejoras específicas que los sujetos pueden experimentar. Este artículo dirige su atención precisamente a evaluar con detalle la eficacia terapéutica del tratamiento de los agresores sexuales de mujeres adultas. Con esta finalidad, se analiza una muestra de agresores sexuales tratados (N=153) que cumplen condena en prisión por un delito contra una mujer adulta. Para ello se evalúa mediante una escala diseñada al efecto (EPAS) el cambio terapéutico global de los sujetos tras el tratamiento y también su evolución en diez variables terapéuticas específicas (como asertividad, disposición al cambio personal, distorsiones cognitivas, etc.). La comparación intra-sujetos indicó que los agresores tratados mejoran, en términos terapéuticos, tanto globalmente como en la mayoría de las variables específicas evaluadas (mejoras que no se produjeron en el grupo control). Así mismo, se encontraron asociaciones significativas relevantes entre diversas variables terapéuticas. Finalmente, se comentan críticamente los resultados obtenidos y algunos de los retos existentes en el campo de la evaluación del tratamiento psicológico de los agresores sexuales (AU)

Therapeutic effects of a cognitive-behavioural treatment with juvenile offenders

Several treatment evaluations have highlighted the effectiveness of cognitivebehavioural programmes with both youth and adult offenders. This paper describes the application and assessment of a cognitive behavioural treatment (adapted to Spanish from Ross and Fabiano’s Reasoning & Rehabilitation Programme) with juvenile offenders serving community orders in an educational measure called in Spanish «libertad vigilada» (similar to parole). The intervention comprised six different therapeutic components: self-control, cognitive restructuring, problem solving, social skills/assertiveness, values/empathy, and relapse prevention. Treatment effectiveness was tested using a quasi-experimental design involving two groups and pre/post evaluation. The results show that the programme was effective (with low to moderate effect sizes) in improving participants’ social skills and self-esteem, as well as in reducing their aggressiveness. However, the intervention had no positive influence on empathy, cognitive distortions or impulsiveness. These results are in line with those of many other correctional studies, in which the treatment applied had a significant but partial effect on participants(AU)

Diferentes estudios han puesto de manifiesto la eficacia de los programas cognitivo-conductuales aplicados como tratamiento en delincuentes adultos y jóvenes. Este trabajo describe la aplicación y evaluación de un tratamiento cognitivo-conductual (una adaptación del programa «Razonamiento y Rehabilitación» de Ross y Fabiano), aplicado a delincuentes juveniles que cumplen sus sanciones en condiciones de libertad vigilada y en contextos comunitarios. El programa de intervención incluía seis componentes terapéuticos: autocontrol, reestructuración cognitiva, resolución de problemas, habilidades sociales / asertividad, valores/empatía y la prevención de recaídas. La efectividad del tratamiento se evaluó mediante un diseño cuasiexperimental en dos grupos y se realizó una evaluación pre / post-tratamiento. Los resultados muestran que el programa fue efectivo (con una magnitud del tamaño del efecto entre baja y moderada) en la mejora de las habilidades sociales de los participantes y la autoestima, así como en la reducción de su agresividad. Sin embargo, la intervención no tuvo influencia positiva en la empatía, las distorsiones cognitivas y la impulsividad. Estos resultados están en línea con muchos otros estudios análogos, en los que el tratamiento aplicado tuvo un efecto significativo, aunque parcial, en los participantes(AU)